EHS-COVID (474) Lessons (not) learned in Peru

25 November, 2021

This letter from a group of doctors in Peru says the 'country failed to learn the lessons identified during the first wave'. The letter talks mainly of COVID-19 and relatively little about essential health services. What lessons have been learned (or not learned) in Peru (and in other countries) from countries' experience of the first or second wave? How easy was it to appl;y these lessons to help withstand future waves?

CITATION: Herrera-Anazco, Percy et al. Some lessons that Peru did not learn before the second wave of COVID-19

International Journal of Health Planning & Management

First published: 17 February 2021 https://doi.org/10.1002/hpm.3135

https://onlinelibrary.wiley.com/doi/full/10.1002/hpm.3135

EXTRACTS

The lack of equipment in public health facilities forced patients to purchase essential supplies such as oxygen from private sellers at unaffordable prices. Even though the vast lack of oxygen increased mortality, the government did not invest in oxygen infrastructure.

On the other hand, the government published a series of COVID-19 guidelines, with an incomplete description of their methodology and evidence assessment. Guidelines included drugs without scientific support on efficacy such as hydroxychloroquine, azithromycin and ivermectin (for hospitalized and ambulatory patients), leading to massive self-medication, millionaire expenses and probably worsened the system's collapse due to the adverse effects. Although some updates have withdrawn some of those, many persist in the guidelines.

Despite the efforts to reach universal health coverage in Peru, a large proportion of the population does not have adequate access to care due to a chronic lack of infrastructure, insufficient human resources, and lack of essential drugs. Most of the pandemic response was directed towards hospitals and particularly towards intensive care units (ICU), disregarding the need for a primary health approach or pre-ICU interventions.

Healthcare workers have been drastically affected by COVID-19. Before the pandemic, reports showed several gaps in the number, distribution and capacities. The situation exacerbated due to the collapse of the healthcare system and insufficient PPE, placing Peruvian healthcare workers among the most affected in the region.

Finally, communication has been deficient at every level. With a highly politicized environment, media and politicians have played a significant role in disinformation. On several occasions by opening the floor to nonscientist or even charlatans to give their opinion on control measures, or promoting different antiscientific approaches. These messages have caused confusion and distrust in the population.

Last January 26, the president decreed a new lockdown in many regions of the country due to the increase in deaths that is close to the highest number per day in the worst stage of the first wave. With a current tremendous increase in the number of cases, ICU patients, and deaths; Peru faces a second wave without resolving many of the problems detected at the beginning of the pandemic. The country failed to learn the lessons identified during the first wave.

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org